California fertility clinic settles lawsuit with lesbian denied treatment

by Zamna Avila

EDGE Media Network Contributor

Tuesday October 27, 2009

As the battle for marriage for gays and lesbians moves forward around the country, the movement continues to achieve other gains.

North Coast Women's Care Medical Group settled a lawsuit last month for an undisclosed amount with Guadalupe Benítez, a lesbian who was denied infertility treatment by one of the clinics doctors based on her sexual orientation.

"I didn't look for this fight; my doctors forced it on me," Benítez said in a statement Lambda Legal issued. "We felt helpless, humiliated and trapped and it's been a long, hard fight to get to this point."

The settlement ended eight years of litigation and may establish a national precedence in civil rights discrimination cases.

Benítez walked into the clinic in 1999 after the health insurance group she had at the time referred her. Her plan had an exclusive contract with North Coast Women's Care. If she were to have gone somewhere else, she would have had to pay for the additional costs her policy did not cover.

"From the first office visit, the doctor with whom she was matched told her she was not going to be treated like other patients because of who she is," Jenny Pizer, senior counsel and director of the National Marriage Project for Lambda Legal, said. "The doctor said to her face, 'I will not treat you like other patients.' And, that type of discrimination against any person is an injury to one's dignity or sense of self."

Beyond the emotional distress, Benítez also experienced other legal injuries. The clinic performed unnecessary tests, medications and surgery, which may not have been needed, that endangered her health and the amount of time she spent waiting for insemination risked her ability to get pregnant.

Although her physician promised her physician she would receive the care she needed with the assistance of doctors who would step in and provide care, he showed Benítez the door after 11 months. The clinic's medical director told Benítez she needed to go other clinic because too many of the staff at North Coast had religious objections to treating her the way they treat other patients. Benitez sued.

Pizer received a call from Benitez and her spouse Joan Clark, shortly after a San Diego trial court threw out the initial suit in 2001. Lambda took the case in 2002. And it took almost two years to go to the U.S. Court of Appeal.

"The medical service of providing infertility treatment is not a religious ritual, it is a medical service."

"Your religious belief is always protected but freedom to act based on religious is not always protected," Pizer argued in court. "In California, it must be the law -we must understand the law to mean - that a Jewish doctor, for example, must treat all patients equally, including Muslims and Arabs and a Christian Fundamentalist doctor must treat Jewish patients equally ... So, this case was about whether one group of people's religious views about another group of people provide an excuse for violating the civil rights law that otherwise would apply."

The California Supreme Court unanimously agreed in Aug. 2008 and ruled religious conflicts did not entitle the clinic or any of its doctors to discriminate against Benítez and other gay patients regardless of religious views. Pizer explained when a doctor has a specialty and provides a particular service to others, then the doctor cannot pick and choose who will receive the service or who will not based on who the patient's identity. Referrals to other doctors or turning a patient away for such a reason as personal trait are in violation of civil rights, unless the patients cannot pay or is non-compliant.

In the case of abortion for example, doctors who do not perform the procedure on moral grounds are protected under the law because they don't specialize in abortions and therefore are not picking and choosing between one group and another group of people to practice their specialty. Doctors choose the area of medicine they want to practice and are expected to provide a standard of care. If a doctor is a surgeon for instance, he or she cannot refuse blood transfusions on moral grounds.

"The medical service of providing infertility treatment is not a religious ritual, it is a medical service," Pizer said. "People are not generally allowed to practice medicine without the medical education and a medical license. If you have the medical education and you've received the license by the state then you are practicing medicine, you are not practicing religion. You are practicing medicine with the authority given to you by the state to practice medicine...you have to practice medicine according to medical standards and according to non-discrimination law."

North County issued a joint statement with Lambda Legal after it settled with Benítez. The clinic said it wanted "all of their patients, including those who are lesbian and gay, to feel welcome and accepted in their medical practice and are committed to treating all of their patients with equal dignity and respect in the context of the highest quality of medical care."

Benítez and her spouse are now raising three children and are happy with the results of the settlement.

Pizer stressed she feels this case raises a much larger question.

"This case ... goes beyond the extraordinary and painful steps that Lupita had to go through, and expensive steps, that Lupita had to go through to receive the infertility care that should have been provided in a very simple direct way," she said. "But it happens in the bigger context of discrimination against LGBT patients that often is more subtle and nonetheless is harmful. Because when patients are treated in a disrespectful caring way by medical professionals, then they frequently, or I should say we frequently, don't go back to the doctors office for a long time; sometimes even until a medical condition has become so acute that its much more difficult to treat or sometimes is not treatable."

Pizer added Benitez vs. Women's Care Medical Group will establish a legal precedent that will be helpful in the struggle for LGBT equality throughout society, not just concerning equal treatment in doctor's offices. She said the case may help in other situations where there is a need to counter people with conservative religious views who discriminate against gays and lesbians because of their faith.

"Just as churches are protected from civil law, civil law needs to be protected by churches," Pizer said. "Those protections go in both directions."